Curing Health Care: First, Do No Harm
by: Penna Dexter - Oct 9, 2007 - comments: 5
I had my annual check-up today. From the look on my internist’s face when he entered the examining room…well…if it had not been a year since I had seen him, I would have thought he was going to tell me I have a dreaded disease.
Instead, he told me something he is telling all his patients: for financial reasons, he finds it necessary to end his practice. He’ll open another one that will charge patients out-of-plan prices and emphasize preventative medicine, some of which will not be covered by insurance.
His plan makes sense, except for the fact that that many, perhaps most, of his current patients will no longer be able to afford his services. And that’s the point. Recent government mandates, limits on how much doctors can receive from insurance companies per procedure, added documentation requirements, and other changes have forced him to increase his patient load to the point where he feels he is no longer able to practice medicine at what he considers the minimally acceptable level.
This excellent and caring physician says he considered joining his father (also a doctor) in a medical-supply business. But, no, he’ll continue serving patients. Those who can afford to see him will benefit, while others will have to find another doctor. His pained description of what forced this decision revealed his “doctor’s heart,” the same heart that led him to tell his patients this news before they receive the official letter. A couple of weeks ago we received one of those letters from my husband’s doctor, who is leaving the practice of medicine altogether.
If you live anywhere near the real world you have noticed the recent huge increases in health insurance premiums and the news reports that 47 million Americans do not have health coverage. Actually they do, because hospitals must treat all who come to their emergency rooms, regardless of their ability to pay. Since some can’t pay, so the rest of us foot the bill.
Into this environment come presidential candidates offering plans for a national health care system. We have taken steps toward such a system since the defeat of HillaryCare in 1994. The recent congressional debate over the State Children’s Health Insurance Program, SCHIP, was really a battle over socializing health care, one citizen-group at a time.
SCHIP was enacted in 1997 to cover poor children. President Bush recently vetoed a $35-billion expansion of the program, seven times the increase he recommended. The increase proposed by Congress would have moved the program well into middle-class territory, covering children from families of four with annual incomes of up to $82,600.
Under the banner of “choices,” Hillary Clinton recently unveiled her plan for “universal health care” using some specific terms whose definitions tell the real story. (I elaborate in parentheses.)
- Individual Mandate – Everyone must have insurance either through an employer or the government. (You breathe. You buy health insurance.)
- Pay or Play – Businesses that don’t provide their employees with health insurance will be taxed. (Some businesses will choose the tax, and their employees will be forced to take advantage of definition #3 below.)
- Public Insurance – Individuals can buy medicare-like insurance from the government based on their ability to pay. This will be subsidized through the repeal of the Bush tax cuts and through certain “efficiencies” the system is expected to produce. (The efficiencies will include paying physicians less than they are now paid for certain procedures and enacting price controls on prescription drugs. This will drive more doctors, like mine, out of the system and will discourage surgical and pharmaceutical innovation. It also will result in longer waiting periods for treatment, and perhaps denial of treatment to the elderly.)
- Guaranteed Issue – Insurers have to offer policies to all applicants.
- Community Rating – Insurers are prohibited from charging different premiums based on health status.
(These last two requirements are possible because young healthy Americans who currently choose not to have heath insurance, or to have high-deductible policies, will be forced back into the system.)
This plan contains elements of Governor Arnold Schwarzenegger’s proposal for California and of the program former Governor Mitt Romney enacted in Massachusetts. There is an element of individual responsibility that conservatives like, but the tendency of companies and individuals to drop private coverage will mean more people will jump into the government-subsidized wagon than stay outside pulling it. Guess how we end up? Like Canada, where citizens pay nearly half their income in taxes and where the national health-care system has been declared to be in a state of crisis.
In a :Wall Street Journal column (Cancer Killers, 9/14/07), Betsy McCaughey, former Lt. Governor of New York and chairman of the Committee to Reduce Infection Deaths, explains why, if you’re going to get cancer, it’s best to do it in this country because, “cancer patients in the U.S. are most likely to be screened regularly, have the fastest access to treatment once they are diagnosed with the disease, and can get new, effective drugs long before they’re available in most other countries.”
Last spring, a British woman was in the news because she appealed to Parliament to get treatment for her cancer diagnosed four months earlier. A study by the Royal College of Radiologists confirms that this is typical and that 13 percent of patients who need radiation never get it because of staff and equipment shortages.
A wealthy and compassionate nation should have an excellent health care system. There’s a heady, benevolent feel to the idea of universal national healthcare—until you consider the costs to the economy, in lives, in efficiency, in innovation and in freedom. Patients travel great distances to avail themselves of our doctors and our facilities. Many of the system’s current problems, especially those driving doctors out of medicine, exist in part because the government has already become too involved in private medical care.
There are market-based and competition-inducing proposals that will help deal with the problem of the uninsured, which, by the way, is a fluid group. David Henderson, research fellow at Stanford’s Hoover Institution, found that 45 percent of Americans who lack health insurance at any given time will have it within four months. Major problems plague our system, but these flaws should not be exaggerated or used as an excuse to consolidate government power over our lives.
Penna Dexter is a board member of the Ethics & Religious Liberty Commission, a conservative activist and an announcer on the syndicated radio program Life on the Line. She currently serves as a consultant for KMA Direct Communications in Plano, Texas, and as a co-host of Jerry Johnson Live, a production of Criswell Communications.
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5 comments (post your own) feed
1 On Oct 9th, 2007, at 1:38pm, Vivian wrote:
fascinating article; much to consider; grateful for the summaries of proposals being considered. thanks!
2 On Oct 9th, 2007, at 6:55pm, Patti wrote:
Anyone who has been in the military will tell you that we do not want government-run health care. My husband was in the military for 20 years. The military health care professionals were good, competent people but did not have the time or resources to adequately take care of all their patients.
3 On Oct 10th, 2007, at 1:43pm, Miles Mullin wrote:
The doctors in question actually had another choice: instead of increasing patient load, dropping insurance patients because the third party payer does not pay enough, or seeking employment in the lucrative medical supply business, some doctors might choose to adjust their own standard of living in order to continue serving the vast majority of patients who rely upon health insurance coverage to get treatment--patients who ostensibly are of the highest important to them.
In addition, don’t forget who really benefits from lower physician reimbursements vis-a-vis higher insurance premiums.
4 On Oct 11th, 2007, at 10:13am, Greg A wrote:
The proposals here are more like the H. Clinton and Edwards plans than any I’ve heard from the GOP candidates.
(I thought that should be pointed out.)
PS: I hear so much complaining from doctors but I just can’t take them seriously.
I have several church friends who are doctors and they have HUGE homes and drive expensive cars. They have second homes in the mountains and take expensive European vacations.
THEN they complain to me about how they aren’t being paid enough. It’s a hard pill to swallow.
If you want to hear stories about REAL financial disaster don’t talk to a doctor—talk to someone who employer doesn’t give them health insurance.
One illness—not even a very serious one—can completely wipe out years of savings and force them to bankruptcy. They aren’t worried about losing the yacht—they are worried about keeping a roof over their heads.
The system IS broke. Don’t let out-of-touch talk radio guys tell you otherwise.
5 On Oct 13th, 2007, at 9:27am, Richard Landess wrote:
Because my son is a podiatrist, I know your statements about doctors dropping out is certainly true. A lot of his friends who are doctors have already done so or established one of those high priced practices you mentioned. We are also losing a lot of our older doctors who would remain in a limited practice, but cannot afford to do so because of the high cost of malpractice insurance and the tendency of juries to award tremendously high sums out of all proportion to any injuries received.